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Drug Class: Non-opioid analgesic Pyrazolone derivative Analgesic & antipyretic (with mild spasmolytic action) Uses / Indications: Moderate to severe pain High fever (refractory to other antipyretics) Postoperative pain Renal or biliary colic Mechanism of Action (MOA): Inhibits prostaglandin synthesis via the COX pathway Acts both centrally and peripherally Provides strong analgesic and antipyretic effects Also exhibits mild antispasmodic activity Dose: Adults: 5001000 mg PO/IV/IM every 68 hours Maximum: 4 g/day Pediatric dosing: weight-based Adverse Effects: Agranulocytosis (rare but serious) Hypotension (especially with IV use) Allergic reactions / anaphylaxis Skin rash GI upset (nausea, vomiting) Drug Interactions: Methotrexate risk of myelosuppression Cyclosporine cyclosporine levels Alcohol CNS depression Other myelosuppressive drugs risk of agranulocytosis Contraindications: History of agranulocytosis Bone marrow suppression Hypersensitivity to pyrazolone derivatives Third trimester of pregnancy Brand Names: Novalgin Analgin Baralgin Clinical Pearl: Metamizole is highly effective for severe pain and high fever, particularly when other analgesics fail

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